A fracture is a break in the continuity of a bone caused by an injury, i.e. an external force. Fractures can affect all bones and can occur in different parts of the bone.
Fractures within the diseased bone are called pathological fractures. They can occur in cases of bone changes, such as, for example, a cyst, tumor, inflammatory lesion. At the site of such a lesion, the bone structure is weakened and in the event of an injury, even a minor one, the bone may fracture at this site.
Fractures occurring in children show their individuality related to the specificity of bone structure in childhood. The most important difference is the presence of growth cartilage, which allows the bones to grow in length. Growth cartilage also affects the ability of spontaneous bone remodeling if bone fragments remain even displaced, within certain limits, of course.
The presence of growth cartilage means that the fracture fissure may run not only through the bone structure itself, but also through the growth cartilage. Therefore, this type of trauma, i.e. fractures within the growth cartilage, does not occur in adults. In contrast, these types of injuries are quite common in children.
General principles of bone fracture treatment
Fractures without displacement or with a slight displacement of the fragments are treated by immobilization in a plaster cast. Classic or special plastics are available. Simple fractures of the forearm bones in children require immobilization from 3 (single bone) to 4-5 weeks (two bones).
Fractures accompanied by the dislocation of the fragments require adjustment and immobilization. If the fracture is stable after adjustment, a plaster cast is placed around it. If the fragments move easily during alignment – they are unstable – then simple stabilization is usually applied, such as with a Kirschner wire inserted through the skin and holding the fragments in the correct position to prevent fragment displacement. Since it is the so-called minimal anastomosis, the limb is additionally immobilized in a plaster cast.
When the fracture cannot be properly positioned conservatively, surgery is performed-it is called an open setting.